Long-term weight loss considered nearly impossible

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Here's a CBC science piece quoting several obesity experts argues that long-term weight loss is almost impossible, saying that (uncited) meta-analyses of weight-loss intervention found that in the 5- to 10-year range, most weight-loss was reversed. According to Tim Caulfield, who holds a Canada Research Chair in Health Law and Policy, this is an open secret in scholarly and scientific weight-loss circles, but no one wants to talk about it for fear that it will scare people off of healthier eating and exercise regimes, which have benefits independent of weight-loss.

I found the article frustrating. While I am willing to stipulate that the data on long-term weight-loss suggests extreme difficulty, I wish the journalist had found biologists or doctors to discuss the issue, and had cited actual, specific research to support the claims made, which would make it easier to parse the nuances in the piece. It's not that I think that interdisciplinary lawyers with an undergraduate science background have something to say on this (I am 100 percent for interdisciplinary researchers, especially on complex questions like obesity), and while I think that psychologists like Traci Mann have a lot to say about some dimensions of weight-loss, it would have been great to find out what endocrinologists and other bioscience-types had to say about the phenomenon.

For my part, I went from about 250 lbs to about 170 in 2002/3, by eating a very low-carb diet. This morning, I weighed in at 176 lbs. I attribute my sustained weight loss to daily swimming (which I do for physiotherapy for chronic back pain) and a moderate-carb diet, as well as a two-day-a-week 600 calorie fasting regime.

Which is to say, it's a ton of work to stay where I am, and I know from past experience that if I skip swimming for a few days, or let myself go nuts on carbs for more than a day or two, or skip fasting-days (which aren't really fasting -- just very low-calorie days) that my weight creeps up. I pretty much never eat without making a complex (and tediously unwelcome) calculation about what I'm about to consume, and I often experience guilt while eating "bad" food and shame afterwards.

Clearly, this is less than optimal!

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"You'll be in a room with very knowledgeable individuals, and everyone in the room will know what the data says and still the message doesn't seem to get out."

In part, that's because it's such a harsh message. "You have to be careful about the stigmatizing nature of that kind of image," Caulfield says. "That's one of the reasons why this myth of weight loss lives on."

Health experts are also afraid people will abandon all efforts to exercise and eat a nutritious diet — behaviour that is important for health and longevity — even if it doesn't result in much weight loss.

Traci Mann says the emphasis should be on measuring health, not weight. "You should still eat right, you should still exercise, doing healthy stuff is still healthy," she said. "It just doesn't make you thin."

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